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目的:评价化疗联合细胞因子诱导的杀伤细胞(CIK)治疗晚期食管癌的疗效。方法:40例非手术治疗的晚期食管癌患者分2组化疗,每组20例。单纯化疗组:顺铂(25mg/m2,静脉滴注,第1～3天)、四氢叶酸钙(100mg,静脉滴注,第1～5天)和5-氟尿嘧啶(500mg/m2,静脉滴注,第1～5天),每3周1次,每2个周期评价疗效,进展患者改为紫杉醇(135mg/m2,静脉滴注,第1天)和顺铂(25mg/m2,静脉滴注,第1～3天),每3周1次。最多化疗6个周期。联合治疗组:化疗方案同上,在每周期化疗间歇期回输CIK6～8次。观察2组患者近期疗效、生活质量、外周血淋巴细胞表型及生存率。结果:联合治疗组和单纯化疗组近期疗效有效率均为35%,疾病控制率分别为65%和50%,差异均无统计学意义(χ2分别为<0.001和0.921,P均>0.05);肿瘤进展时间分别为(8.9±1.1)和(6.7±0.7)个月(t=7.295,P<0.001);1a生存率分别为75%、40%(χ2=5.013,P=0.025)。联合治疗组患者外周血CD3+、CD4+、CD4+CD8+、CD3+CD56+细胞的比例及KPS评分较治疗前升高(t分别为11.344、13.056、3.891、16.844及3.025,P<0.05),单纯化疗组无明显变化(P>0.05)。结论:化疗联合CIK治疗晚期食管癌较单纯化疗有潜在的优势。
Objective: To evaluate the efficacy of chemotherapy combined with cytokine-induced killer cells (CIK) in the treatment of advanced esophageal cancer. Methods: Forty patients with advanced esophageal cancer who underwent nonsurgical treatment were divided into two groups, 20 patients in each group. Patients in the chemotherapy alone group were treated with cisplatin (25 mg / m2, intravenous infusion, days 1 to 3), calcium leucovorin (100 mg intravenously, days 1 to 5) and 5-fluorouracil (Day 1 to day 5), cisplatin (25 mg / m2, intravenous infusion Note, 1 to 3 days), once every 3 weeks. Up to 6 cycles of chemotherapy. Combination therapy group: chemotherapy regiment ibid, CIK6-8 times per cycle chemotherapy infusion. The curative effect, quality of life, phenotype and survival rate of peripheral blood lymphocytes in two groups were observed. Results: The immediate curative effect was 35% and the disease control rates were 65% and 50% respectively in the combined treatment group and the simple chemotherapy group. There was no significant difference between the two groups (χ2 = 0.001 and 0.921, P> 0.05). The tumor progression time was (8.9 ± 1.1) and (6.7 ± 0.7) months respectively (t = 7.295, P <0.001). The survival rates of 1a were 75% and 40% respectively (χ2 = 5.013, P = 0.025). The proportion of CD3 +, CD4 +, CD4 + CD8 +, CD3 + CD56 + cells and KPS in the combined treatment group were significantly higher than those before treatment (t = 11.344,13.056,3.891,16.844 and 3.025, respectively, P <0.05) No significant change (P> 0.05). Conclusion: Chemotherapy combined with CIK has the potential advantage over chemotherapy alone in the treatment of advanced esophageal cancer.